The influence of adrenergic blockade in rats with apical periodontitis under chronic stress conditions

Objective: To investigate the influence of chronic stress and adrenergic blockade in a rat model of apical periodontitis. Methods: Thirty-two Wistar rats were submitted to an animal model of periapical lesion and randomly divided into 4 groups (n = 8): no stress (NS); stress + saline solution (SS); stress + beta-adrenergic blocker (S beta); stress + alpha-adrenergic blocker (S alpha). The SS, S beta and S alpha groups were submitted to an animal model of chronic stress for 28 days and received daily injections of saline solution, propranolol (beta adrenergic blocker) and phentolamine (alpha adrenergic blocker), respectively. After 28 days the animals were euthanized and the following analyses were carried out a) serum corticosterone levels through Radioimmunoassay; b) measurement of serum levels of IL-1B, IL-6, IL-10 and IL-17 by enzyme-linked immunosorbent assay (ELISA); c) volume of periapical bone resorption by micro-computed tomography; d) histomorphometric analysis by staining with hematoxylin and eosin; e) expression of beta-AR, alpha-AR, receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) by immunohistochemistry; f) tartrate-resistant acid phosphatase (TRAP) staining; g) ex-vivo cytokine release followed by the stimulation with LPS in superfusion system, by ELISA. Results: SS group displayed significantly higher corticosterone levels than NS group (non-stressed). Higher IL-15 serum level was observed in the NS group (p < .05); compared to all stressed groups. Other cytokines were present in similar amounts in the serum of all groups. All groups presented similar periapical lesions. All groups presented moderate inflammatory infiltrate, without statistically significant differences between them. No differences were observed regarding beta-AR, alpha-AR, Rank-L and OPG expression. The number of TRAP-positive cells was significantly decreased in the groups that received daily injections of adrenergic blockers. The IL-15 release followed LPS stimulation was significantly suppressed when the superfusion media contained propranolol (p < .05). Perfusion containing phentolamine induced a greater release of IL-10. TGF-beta was significantly suppressed by phentolamine perfusion in the NS group (p < .05). Conclusions: Chronic stress can significantly change the inflammatory cytokines release. Rank-L/OPG system and periapical lesion volume were not affected following the current method applied. The administration of adrenergic blockers was not able to modulate the inflammatory response but presented effectivity in reducing the number of osteoclasts in the periapical region.